Fox News Asks, Can Autism Be Prevented?

It’s happened again at Fox. After taking down a story last year that was packed with misinformation about genetically modified foods–headlined “What you need to know“–Fox has now offered up another similarly underevidenced article, this time headlined “Can autism be prevented?”

Short answer: No, not usually.

In spite of that, the article goes longer and turns to one ‘Rober’ (sic) Melillo, who practices something called “chiropractic neurology.” The unbylined article says about autism:

The statistic rates used to be one in 150 – so how did we get these new numbers? Dr. Rober Melillo, co-founder of the Brain Balance Achievement Centers, spoke with Dr. Manny Alvarez, senior managing health editor for FoxNews.com, about the science behind autism, as well the facts and myths surrounding the condition.

Melillo, in fact, does neither. Instead, he exhibits a rather basic grasp of genetics, blames the autism “epidemic” completely on environmental factors, and then, the article says, blames genetic “predisposition” and environmental factors together. If you’re confused and need some clarity, well guess what? Melillo’s got a book to sell you. The article says:

Fortunately, Melillo identified numerous preventative measures parents can take to better ensure their child will not be born with autism. All of these measures are included in his book, Autism: The Scientific Truth About Preventing, Diagnosing, and Treating Autism Spectrum Disorder — and What Parents Can Do Now.

Autistic individuals tend to use different areas of the brain (yellow) for a movement task compared to a control group (blue). Powell K. Opening a window to the autistic brain. PLoS Biol . 2004 ;2(8) :E267. doi:10.1371/journal.pbio.0020267. PMID 15314667. PMC 509312. (Photo credit: Wikipedia)

Natch. Most of the “measures” remain hidden in the pages of this book–which you can purchase!–but the one the article cites? Prenatal vitamins. Raise your hand if you took prenatal horsepills before, during, and after pregnancy and still had a child with autism. Melillo seems to be referencing this paper but misinterpreting the odds ratio data. The authors note the limitations of their study here in the full text of the article, which included that it relied on maternal recall of vitamin intake around pregnancy, several years after the pregnancy. They also did not collect information on diet. So, sure, take your prenatal vitamin, but don’t do it because you think it’ll prevent autism.

Melillo then helpfully offers that autism is “essentially an imbalance in the brain.” That’s likely useful for him to say because, as you might have noted above, he’s the co-founder of the Brain Balance Centers, offering a proprietary program and franchises scattered around the country. Their operating basis is this “imbalance in the brain.” I once wrote a critique of what I found on the Brain Balance Centers website (warning: critique’s a snarkorama), which brought not only a whole lot of very similar comments in favor of the centers but also a series of emails from various center administrators. It was … interesting. In spite of my comments on and exploration of the irrelevant references the Brain Balance Center cites here, these unhelpful citations still remain on their page called “The Truth.”

After offering in the FoxNews article the further cutting-edge observation that research into the mechanisms of autism is “going towards understanding what is really happening,” Melillo suggests that most allergies and food sensitivities and immune problems “really start in the brain.” That’s such a huge, general statement that I’ll just generally respond, No, they generally don’t. Blame your bones or the thymus or T cells or B cells, but don’t blame the brain.

Obviously, Melillo has every right to peddle his book in high-value venues and to set up centers that trumpet ‘cures’ for autism, ADHD, dyslexia, and Tourette’s. What baffles me is why the “senior managing health editor” at FoxNews thought that it was OK to let Melillo do this bit of unscientific PR-related marketing on his watch, particularly given the abundance of genuine autism experts who could have been asked instead.

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If you think of “causes” in terms of billions of Mah Jong pieces to represent the bits of info in DNA, and each couple can have over 200,000 different genetic combinations (200,000 possible children), then some of those bits are going to hit in all sorts of complicated ways we don’t understand yet. Probably we won’t understand them for a long time and even then, will people be willing or able to pay for the extensive computer analysis that would be required to determine how their baby will develop?

Well, I haven’t read the book by this guy on Fox news (strike 1!), but it does seem to me that the recent analysis on risk factors indicates we can try to reduce the risk of having a child with autism by taking some steps. I wouldn’t call it prevention, but maybe risk mitigation.

1) Don’t wait until you are 35 or 40 to start having children. Our bodies were designed to start having babies two decades before that. Clearly there are other problems with having a child at 15, but from the viewpoint of risk mitigation, this is a good one with robust findings indicating increased risk with advanced parental age.

2) Don’t take valporic acid (or similar drugs?) while pregnant! While there may be some confounding problems with *needing* such medications in the first place, it seems like the animal based literature on disturbances to developmental outcome using ‘regular’ rats tells us that the pathway is biologically plausible.

3) If you are obese, lose some weight before having a baby. It’ll probably help you conceive anyways.

4) Similarly, if you have a metabolic* dysfunction, or other condition characterized by increased inflammation, get it under control before getting pregnant. Again, probably a good idea no matter what.

Other ideas with even more bonus speculation include:

5) Antipyretics if you get sick while pregnant. Of course, no telling what else they *might* do, and the protective measures were found in a Questionnaire style study. It would seem to mesh nicely with approximately 398293 animal studies on immune challenge during pregnancy. There might be other things you could take to ameliorate the immune response in particular to brain changes, with some *very speculative* animal studies to back them up, but I won’t mention them here. I think we’ll have some ideas on that in the medium or long term.

6) Get pregnant at the right time. The findings on seasonality of birth and risk of schizophrenia are very robust; the autism data is relatively small in comparison, and somewhat scattered, probably the result of how poor we are at identifying autism. I don’t think the ‘right’ time to conceive is known, and probably depends on what side of the equator you are on, but this will be figured out sooner or later.

If you did all these things *just right* you’d probably (?) reduce your risk of having a child with autism *some* (how much?), but ‘prevention’ wouldn’t be the right word.

And you also make a good point, which I didn’t get into in the article: “Risk” is not the same as “causes,” and what you’ve addressed here has to do with factors correlated with increased risk. Addressing any or all wouldn’t be a “preventative,” even if they indeed confer increased risk.

I have to site an article written by you, Emily Willingham, today, Feb. 8. The article I’m referring to is “Can Nerd Nodes Reach Resistors of Scientific Consensus”. You wrote the following:

“After listening and reading, I’ve determined that when it comes to softening resistance to scientific consensus–not ‘denialism’–the worst possible thing to do is to act like you are Science with a capital S, speaking from on high to the little people who just don’t get it. People who push back against scientific consensus aren’t lesser humans somehow, and often, they “get” science quite sufficiently enough. The place to effect change isn’t from a pedestal. It’s from within the social networks of communities with shared values and ideas.”